Many women with infertility suffer from tubal effusion, which is statistically the most common indication for in vitro fertilization-embryo transfer (IVF-ET). It is believed that hydrosalpinx can reverse the flow into the uterine cavity, flushing the embryo away from the implantation site and interfering with embryo implantation. In addition, it has been shown that the fluid is a hypotonic, low lactate, low protein solution, which has toxic effects on embryonic development, as well as inflammatory and immune factors that inhibit embryonic development and have toxic effects on sperm viability. Tubal disease accounts for about 1/3 of female infertility, and hydrocele accounts for 10%-30% of tubal infertility. The exact mechanism of pathogenesis is still unclear, but numerous studies have shown that tubal effusion negatively affects the outcome of IVF-ET. A large number of retrospective studies and meta-analyses have statistically shown that hydrocele reduces IVF-ET pregnancy rate by 50% and increases spontaneous abortion rate by 2-fold. It is important to choose the treatment plan to improve the success rate of IVF-ET due to tubal effusion. 1.What is hydrocele? Hydrocele is a more common type of chronic tubal inflammation. After tubal inflammation, the secretion of mucosal cells accumulates in the lumen due to adhesions and atresia, or the isthmus and umbilical adhesions occur due to tubal inflammation, and after blockage, tubal pus is formed, and when the pus cells in the lumen are absorbed, it eventually becomes watery liquid, or some liquid is absorbed and left as an empty shell, which shows hydrocele on imaging. 2.How is hydrosalpinx caused? Abortion, spontaneous abortion, medical abortion, induction of labor, unclean sexual intercourse, pelvic infection and other causes of tubal wall adhesion, congestion, edema and obstruction, that is, due to acute tubal infection treatment is incomplete or untimely and lead to tubal mucosal adhesion, but also by incomplete abortion, residual placenta triggered inflammation, individual with intrauterine device, secondary to chronic tubal inflammation long-term inflammatory stimulation of tubal thickening, hardening, luminal adhesion, In some cases, chronic inflammatory irritation secondary to intrauterine device may cause thickening, stiffening, lumen adhesion and narrowing of the fallopian tubes, and adhesion and atresia in different locations. 3. What are the symptoms of hydrosalpinx? As the lumen of the dilated and undilated part of the fallopian tube can still be connected when hydrocele is present, the patient often has intermittent vaginal discharge and infertility is often the only manifestation of hydrocele. Most patients with tubal obstruction have chronic pelvic inflammatory manifestations, such as pain on one or both sides of the abdomen, cramping, discharge and back pain. Despite the fact that hydrocele can present these symptoms, many patients come to the clinic because of infertility. 4. How to treat hydrosalpinx? There are various methods to deal with hydrosalpinx, such as tubal aspiration, tubectomy, proximal tubal ligation + distal ostomy, proximal tubal cautery, proximal tubal embolization, and interventional ultrasound sclerotherapy. Clinical data show that all of these methods have certain therapeutic effects and solve the problems for patients with infertility. Transvaginal ultrasound-guided tubal aspiration can reduce the pressure in the fallopian tubes, prevent the flow of fluid to the embryo, and block the toxic effect of fluid in the fallopian tubes on the embryo, but the fluid is likely to recur after aspiration. Tubectomy can be a radical solution to the effects of fluid retention on pregnancy preparation. The best management is to assess the functional status of the fallopian tubes and their mucosa during laparoscopy and to make an immediate decision to remove the tubes or to preserve and reconstruct them. It has been shown that patients with tubal effusion have a significantly higher clinical pregnancy rate after tubal resection, and that tubal effusion does not recur and has a significantly lower miscarriage rate after tubal resection compared to vaginal ultrasound aspiration of effusion and tubal ostomy. Laparoscopic proximal tubal ligation in patients with hydrosalpinx has similar pregnancy outcomes in IVF cycles as laparoscopic prophylactic salpingo-oophorectomy, and is an effective treatment for hydrosalpinx. Our center is currently performing aspiration and tubal embolization for patients with hydrosalpinx, all of which have shown good outcomes. In particular, tubal embolization for hydrocele has brought great benefits to patients with infertility. A large amount of clinical data shows that tubal embolization is an innovative and effective method for pretreatment and treatment of hydrosalpinx. In conclusion, patients with hydrosalpinx have poor outcome of IVF treatment and should be actively treated after hydrosalpinx is found.